ORIGINAL POST
In reading Carey’s March 3, 2012 post on OandP.com, I also wonder why
Medicare pays for sales reps and physicians’ office personnel to provide
orthotic items while orthotic facilities have stringent education
requirements for persons who see patients.
Also, we’ve heard of physician’s who have been busted for cranking out
illegitimate billings. We should be able to help Medicare weed out fraud. if
street addresses of places that bill L-codes to Medicare were made public on
the Internet.of is this already available? Randy McFarland, CPO Fullerton,
CA
RESPONSES
Obviously Medicare doesn’t pay anyone who doesn’t have a supplier number.
Donjoy uses addresses of the Physician office where DJ has stock and bill.
Obviously, there is no signage and often no DJ employee there. They do this
for Tricare as well.
In addition to that, what about the fact that PT’s can bill under their
codes for orthotic/prosthetic evaluation, but we don’t have a way to be paid
for evaluations. I do not subscribe to the fact that the eval is wrapped up
into our L codes. Whoever agreed to that in the years past, didn’t perform
appropriate evaluations. Just my personal thoughts.
There issue is not the lumping of orhotic items, but the distinction between
the types of orthotic items. The certification signifies a minimum standard
of care, not education. However, they sometimes are linked or influence
each other. CMS does have a website for providers. It is based on zip code.
www.medicare.gov/supplier/
We have no restrictions on who sees patients in our offices. Anyone can
work in our office “under supervision” and see patients. This is exactly
the same as it is for the physicians. Look into what qualifies as
“supervision” and you may be very disappointed in our “stringent education
requirements”. We need to cleanup our own behavior before we go throwing
stones at other professions.
You are spot on. My practice is in Tampa and stock and bills are running
rampant. Speaking of fraud, a patient told me yesterday that she was charged
$200.00 over and above billing M.Care for a
L1906. Unbelievable. We are being pushed and pushed to The point of saying
Fu@# it. ABC, AOPA, THE ACADEMY as well as other so called advocates of our
profession are doing nothing to help in this major concern.
Don’t be late with your dues though.
Did you watch the latest NAAOP update video that I posted to the listserv?
If not, please check it out. Some of these issues may be addressed by what
we are working on legislatively. Paul P.
